BackgroundPostnatal care (PNC) in rural areas is characterised by low uptake, with possible effect on maternal and neonatal mortality rates. Mobile health (mHealth) communication has been proposed to promote the uptake of health services; however, there is limited information on how mHealth can strengthen PNC in rural areas. The objective of this review was to gather the best available evidence regarding mHealth communication to strengthen PNC in rural areas.MethodsStudies published between 1 January 2008 and 31 August 2018 were searched in electronic databases hosted by EBSCO Host. Reference list checking and contact with authors were also done. Critical appraisal of the eligible studies was also done.ResultsThe results of 11 articles were synthesised to report the determinants of PNC uptake. Determinants were aligned to the Integrative Model of Behaviural Prediction (IMBP). One-way mobile phone messaging was the most common type of mHealth communication used. mHealth communication influenced mothers’ intentions, skills, and environmental constraints associated with uptake of PNC. Intentions were influenced by attitudes, perceived norms and self-efficacy. Positive attitudes, as well as changed attitudes toward PNC practices were observed. Perceived norms that were enhanced were delivery at a health facility with immediate PNC, seeking of reinforcement and professional health support of newborn care practices, and male partner support. Improved self-efficacy was demonstrated by mothers who attended scheduled appointments and they were confident with regard to newborn care practices. Skills for PNC that were improved included cord care, thermal care, appropriate breastfeeding and problem-solving. The environmental constraints faced and which were addressed in the studies included inaccessibility, unavailability and unaffordability of PNC services in rural areas.ConclusionsResults from the literature included in this study show that one-way mobile phone messaging is the common type of mHealth communication used to strengthen PNC in rural areas. mHealth communication can influence intentions, skills and environmental constraints as determinants of PNC uptake. mHealth communication is recommended to strengthen PNC in rural areas. To widen the evidence, more studies in the field of mHealth communication that report a variety of both maternal and neonatal outcomes are needed.
Aims:The main objective of this study was to determine the uptake of the intrauterine device (IUD) among women seeking family planning (FP) services at Level 4 public hospitals in Nairobi County.
Methods:This was a descriptive, cross-sectional study that used both quantitative and qualitative approaches. Interviewer-administered, semi-structured questionnaires, focus group discussions and key informant interviews were used to collect data. Sample size was 380 women with 100% response rate.
Findings:The uptake of IUD was 7.9% (95% confidence interval (CI): 2.6-13.2%). The uptake increased with age, with those aged above 30 years using the device more compared with those aged below 30 years. Drivers of IUD uptake included: parity (adjusted odds ratio (aOR)=8.545 CI: 4.399-16.599%,P<0.001), awareness of IUD provision in the facility (aOR=1.824, P=0.038) and a favourable perception of IUD (aOR=5.816, P<0.001). The qualitative data from the focus group discussion included common myths such as: 'IUD might travel to other body organs' and 'it spreads infection in the body'.
Conclusion:Uptake is low in the two hospitals and more awareness should be created on IUD availability. Uptake should be encouraged among young women and those of lower parity.
Background: The high maternal and neonatal deaths remain a global concern especially in Low- and Middle-Income Countries. This is largely attributed to the limited skilled workforce including midwives who are required to offer quality maternal and neonatal care. Advanced Practice Midwifery (APM) training has been highlighted as critical in achieving high-quality maternal and neonatal care in all settings and countries. In Kenya, the APM training is at the initial stages, having been launched in May 2022. This paper presents the results of a literature review regarding opportunities and challenges for the APM training and practice with a goal of availing information to any institution willing to begin the program in Kenya and other LMICs. Methodology: A descriptive overview was undertaken through a rapid literature review of the relevant local and international literature to highlight the opportunities and challenges for the APM training and practice based on the Kenyan Context. Results: The APM training and practice has expansive opportunities such as the increased demand for quality care and reduced cost services, supportive policies, advances in technology, profession recognition and regularisation of the training and availability of midwives trained at lower levels. The challenges that the APM training is likely to experience includes; Lack of expert trainers, technological challenges, workload challenges due to the high population in need of the services and clinical environment challenges. Conclusion: APM training and practice has enormous opportunities despite the challenges that may be experienced. Therefore, for any institution preparing to start the APM training, there is need to exploit the existing opportunities and address the likely challenges to ensure the APM training and practice meets the desired outcomes.
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